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Introducing the Document Navigator

An AI-supported application for the automated processing of documents in claims settlement

The Document Navigator from Actineo, a Verisk business, classifies and sorts incoming documents, extracts relevant information from any file format depending on the defined use case, structures it and makes it available validated for any end formats and interfaces. With the help of the AI-supported application, insurance customers receive quality-assured documents and data from Actineo for the end-to-end digitalisation of their claims settlement.

Whether it's a clinic report, invoice, lawyer's letter, craftsman's invoice or workshop report - in principle, any type of document can be digitised, structured and made manageable to an unlimited extent with the Document Navigator on the basis of machine learning. Visualisation, automatic validation and manual completion take place according to sets of rules that are configured together with the respective insurance customer. The use cases do not necessarily have to come from the claims area. Use cases from all other areas of the insurance business are also conceivable.

Today, documents from all lines of business often reach the insurer as e-mails, fax reports or postal mail. Heterogeneity in the document structure, redundant document storage and lack of transparency often determined the files.

Actineo has been offering insurers for personal injury claims the extraction and structuring of medical data as part of document retrieval for some time. With the Document Navigator, this area of case management is now also mapped in a completely digitalised process, thus further accelerating the settlement in personal injury.

Intelligent reading of medical documents

Using Optical Character Recognition (OCR) and Artificial Intelligence (AI) applications, the Document Navigator reads complex medical files, breaks them down into their individual components, structures documents, classifies them and eliminates duplicates. In a subsequent step, relevant data such as master data, diagnoses, treatment recommendations or permanent damage assessments are read out of the documents.

These are then visually available in the Document Navigator in Actineo's claims systems or in other (web) applications. In all output formats, the information can be searched, sorted and edited. Alternatively, pre-structured data can be integrated directly via the GDV or another external interface as well as via mobile applications and via the Document Navigator.

Right-Touch Approach: Technology and Expertise

Actineo supports with the Intelligent Document Navigator both in the processing of current claims and in the analysis of historical databases. The use cases described above support Actineo's insurance customers on the one hand in operational claims processing and risk management, but also enable cross-case controlling and data-supported development of models for any use cases by means of "machine file analyses" based on historical data stocks in the insurers' archives. The system-inherent quality assurance in the Document Navigator should be emphasised. The process is structured in such a way that (medical) claims handlers check again after automated document processing whether the documents were correctly classified in the AI-supported process and whether the data were correctly and completely recorded. If necessary, the documents are supplemented manually and fed back into the process as validated data.

Added value quality assurance

"As an InsurTech, we want to support our insurance customers with digital approaches in every area of claims settlement," explains Marco Meisen, Managing Director and CTO at Actineo. "The Document Navigator also uses our right-touch approach, in which technology and data are complemented by the expertise of Actineo claims professionals. In this way, we enable a digital and at the same time holistic view of cases in the claims ecosystem."

Photo: Sascha Bosshard/unsplash.com

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